- Usually from Hashiomoto's thyroiditis
- Can also occur s/p Graves, following thyroiditis, or after treatment of hyperthyroidism
 
   
           
        
        
        
        
        
          
          
            
  
      
        
        
        
        
          
            
                - Constipation
- Weakness
- Fatigue
 
       
    
    
      
        
            - Cold intolerance
- Depression/mood change
- Rarely SOB/DOE from compression of trachea
 
   
           
        
        
        
          
          
            
  
      
    
    
      
        
            - Often no findings aside from wt gain
- Sometimes decreased relaxation phase of reflexes
- Pre-tibial edema or generalized fluid retention
- Lateral thinning of eyebrows
- Thyroid gland can be normal (or enlarged)
 
   
           
        
       
      
      
  
  
    
      - Elevated TSH, decreased T4; Unless central cause (i.e. hypothalamic/pituitary), in which case TSH low
- W/Hashimoto's, anti-TPO ab +; sometimes helpful in setting sub-clinical hypothyroidism (TSH elevated,  T4 nl)